Pregnancy Preparation with Dr. Fleming

Dr. Fleming MD, CCFP, FCFP

The preconception visit is a key visit to the doctor’s office. The reason for this is that many complications of pregnancy are related to lifestyle. The Society of Obstetricians and Gynecologists of Canada suggest that physicians review medical history with all women of childbearing age prior to their conceiving.

Lifestyle issues to discuss include body mass index (BMI), as high BMI’s are associated with an increased risk of gestational diabetes, preeclampsia, and cesarean section. This is a modifiable risk factor best tackled before becoming pregnant. It is now well recognized that preconception and prenatal folic acid intake significantly reduces the risk for neural tube defects. This supplementation needs to begin prior to conception and so requires women to be aware of this recommendation prior to planning a pregnancy. Smoking and alcohol consumption both can have significant impacts on pregnancy. We are aiming to decrease fetal alcohol spectrum disorder which is a developmental disorder associated with alcohol use in pregnancy. Smoking in pregnancy is associated with low birth weight and sudden infant death syndrome.

The other area to discuss with your doctor prior to conceiving is your individual risk for genetic diseases. There are certain ethnic groups with an increased risk of certain genetic diseases. Those of Ashkenazi (Eastern European) Jewish descent can be tested for seven genetic diseases to assess their carrier state. Those of Mediterranean or African descent may be at risk for hemoglominopathies (thallassemia or sickle cell) etc.

You should ensure all immunizations are updated prior to conceiving as rubella (German measles), Varicella (chicken pox), and Pertussis (whopping cough) can have significant implications on a pregnancy and the risk can be significantly reduced or abolished with vaccination.